A baby girl who died within minutes of being born at the Causeway Hospital “would have been absolutely fine” if she had been born at her due date, a coroner heard on Monday.
Consultant obstetrician Dr Lorraine Johnston told the coroner’s inquest that had Tracy Hook’s labour been induced two weeks earlier, baby Alexis Hook would have been born fit and healthy, but that even if she had been induced a week earlier, “I don’t know – she may well have had the same problems in labour”.
Two weeks after her due date, baby Alexis was born by emergency Caesarean section in the early hours of July 4 2012 at the Causeway Hospital in Coleraine.
Although alive initially, within minutes she had developed breathing problems and despite efforts to resuscitate her she tragically died, leaving the lives of her parents Tracy and Allistair “ruined” as Mrs Hook put it.
Senior coroner John Leckey said that during the course of the inquest, set to last up to two weeks, issues he would be looking at were when and in what way medical staff diagnosed established labour, and when a decision was taken to perform the emergency C section.
Consultant neonatal and paediatric pathologist Dr Claire Thornton testified that Alexis’ death was due to asphyxia or a lack of oxygen brought about by her inhaling merconium or “baby poo,” describing how babies open their bowels inside the womb when they become distressed.
Other factors which contributed, said the doctor, were a uterine infection and an insufficient placenta, but she added that the insufficient placenta was common in pregnancies which had gone overdue.
Visibly upset and crying as she took the oath, Mrs Hook’s statement was read to the court where she described finding out she was pregnant with the couple’s first child on the day they came home from their honeymoon.
“We were delighted and have a good support network of family,” said the statement, recounting that her pregnancy was essentially normal and without incident.
However, when little Alexis was born “we didn’t realise she was so sick”.
“I kept telling Allistair that it would be ok because they were working with her. I was taken to recovery and after that I was told Alexis had died.
“We got sometime with her after she died. When I got to hold her she had died. We were devastated. This has completely ruined our lives and plans,” said Mrs Hook, a beauty salon owner from Windyhall in Coleraine.
In a second statement, she described how she had repeatedly gone to the hospital with “tightenings” towards the end of June but that her cervix was “still unfavourable” for giving birth naturally.
On July 2 however, a day before her labour was scheduled to be induced, Mrs Hook was back at the hospital and although staff told her she could go home as they were understaffed, “I did not want to do so” so she was admitted into a side room.
Gels to induce labour were inserted the following day with her pain levels becoming increasingly more severe as the day progressed, and her waters were broken manually by a doctor at one stage, but Mr Leckey heard that between 19.30 and 22.40, no internal examination was conducted.
In her husband’s statement, Mr Hook described how “no one came near her” at that stage but that he repeatedly had to ask for kidney dishes as his wife was vomiting.
“I actually brought the dirty dishes back out thinking it might prompt them to do something, it didn’t,” said Mr Hook, adding that “I eventually got the hold of a midwife ... and I asked if anybody was actually going to examine Tracy.”
Transferred to the delivery suite, a doctor examined Tracy and the printout of the baby’s heart rate, and asked for Dr Johnston to be contacted, and it was when the consultant arrived that the “decision was taken immediately to take her to theatre”.
Mr Hook’s statement lamented that even while he and his wife were in the recovery room, “they continued their efforts to resuscitate Alexis but by that point I knew it wasn’t going to work”.
“The doctors came out and simply shook their heads and said that they were sorry,” said Mr Hook, adding in the statement that later on, doctors explained how the merconium Alexis had ingested was so thick she could not breathe and that there would have to be an autopsy.
Dr Johnston said she was at home when a midwife contacted her at 12.15am on July 4. She told the court that because there were difficulties interpreting the trace on Alexis’ heart rate, she told the staff on the ward to wait until she examined Mrs Hook which happened at 1.05am.
At 1.23am Dr Johnston made the decision to perform the emergency C section and at 1.43am Alexis was born.
Under cross examination from the Hooks’ family solicitor, Paddy Mellarkey, Dr Johnston agreed that had there been more frequent internal examinations, established labour would have been diagnosed sooner and as a consequence of that, a closer eye would have been kept on Mrs Hook and her baby and there would have been “earlier intervention”.